Diabetic retinopathy (DR) is a major ocular complication for persons with diabetes mellitus (DM), particularly for African American patients with type 1 (insulin-dependent) DM. While many of the factors involved in the etiogenesis of DR remain to be resolved, there are experimental, clinical, and gene polymorphism data that indicate that the inflammation that is present in DR may represent a key element in DR development. Because of small sample size and/or cross-sectional study designs, results from previous studies of the role of inflammation in DR are inconclusive. To investigate the role of inflammation in the pathogenesis of DR, we will use data from our well-characterized longitudinal study of a large cohort of type 1 diabetic African Americans, for whom we have baseline and 6-year follow-up data. Moreover, we have plasma samples that were collected from these patients at the baseline examination and that are currently frozen at -70C. We hypothesize that inflammatory biomarkers can be predictive of progression of DR. To this end, we will (i) measure baseline plasma levels of inflammatory biomarkers and determine their relationship to progression of DR, as determined at the 6-year follow-up examination;(ii) examine the same biomarkers relative to baseline prevalence of DR. From this two-step approach, we will differentiate biomarkers only associated with DR progression, true predictors;(iii) examine the specificity of the those biomarkers found to be true predictors in relation to progression of DR by statistically adjusting for known clinical risk factors for (i) progression of DR and (ii) presence of cardiovascular and renal disease . Results from these studies are expected to shed light on the role of inflammation as an early event in the etiogenesis of DR, thus permitting development of treatment modalities to reduce the severity of the disease for all patients with diabetes.